Abstract
The BreastScreen Australia Program commenced in 1991. Since then a national network of breast cancer screening services has been established including Screening and Assessment Services, satellite, relocatable and mobile services. In 2000–2001 the Program screened more than half a million women. The national age-standardised participation rate for women in the target age group 50–69 years was 56.9%. The participation rate varied across States/Territories ranging from 46.3% in Northern Territory to 64.3% in South Australia. A key objective of the Program is to ensure equitable participation across all sectors of the community. The Program has achieved a relatively high level of equity in screening women across socioeconomic, cultural and geographically rural/remote groups. There was no decline in participation with decreasing socioeconomic status, with only marginal differences for the most and least disadvantaged groups at 55.9% and 55.3%, respectively. Participation in regional, rural and remote areas is significantly higher than the national participation rate, ranging from 62.1% for regional centres to 57.9% in remote areas. This presentation will illustrate with pictures and discuss access to breast cancer screening in Australia, specifically the challenges of providing services across vast distances in rural and remote Queensland.
Highlights
Neoplastic tissue contains elevated levels of choline-containing metabolites [1,2]
We examined the extent to which the lower mammographic sensitivity found in hormone replacement therapy (HRT) users could be explained by any association of HRT use with higher density and more difficult to detect cancers
The results suggest that applying compression does not ensure breast thickness reduction and observing physical changes does not guarantee that breast thickness has been minimised
Summary
Neoplastic tissue contains elevated levels of choline-containing metabolites (tCho) [1,2]. The presence of spiculation arising from a mass detected at mammography makes malignancy a probable diagnosis This is confirmed by this review of the first 8 years of screening in East Sussex where only 3.6% of masses with spiculation were benign at excision (24 out of 668), compared with 33.3% of masses without spiculation (102 out of 306). When breast core biopsy reveals lobular neoplasia (lobular carcinoma in situ [LCIS] or atypical lobular hyperplasia [ALH]) a management dilemma follows, as uncertainty regarding the significance of LCIS/ALH exists. Is this an indicator of increased risk of breast cancer or should it be considered a marker for more serious local pathology? Is this an indicator of increased risk of breast cancer or should it be considered a marker for more serious local pathology? Should surgical excision be undertaken in these cases?
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